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REPORT 



OF THE 



IN REPLY TO INTERROGATORIES OF 

ISAAC TOWN SEND, 

PRESIDENT OF THE BOARD OF GOVERNORS OF THE ALMS HOUSE : 

UPON 

CONSTITUTIONAL SYPHILIS. 



Office of the Governers of the Alms House, > 

Rotunda, Park, New-York, Aug. 24, 1855. ) 

To the Medical Board, Bellevue Hospital: 
Gentlemen : — i 

I am led to believe that a 
large number of the inmates of Bellevue Hospital 
are affected with Syphilis in some of its many 
forms, and believing that the Governors of the 
Alms House are called upon to take measures to 
remove, as far as possible, the cause of this great 
malady— to dry up the sources of an evil which 
prevails so extensively, saps the health and taxes the 






the wealth of the City, &c., largely, and believing 
further, that if the vice cannot be stayed, humanity 
as well as policy would suggest that the dangers 
which surround it can be lessened, I propose a few 
interrogatories, tending toward the accomplishment 
of this great object, desiring your views upon them 
in reply, as early as 1st of October. 

1st. What per centage of the total number of 
patients admitted to Bel lev ue Hospital suffer di- 
rectly or indirectly from Syphilis 1 

2d. Are there not patients admitted to Bellevue 
Hospital whose diseases are attributable to the taint 
of Syphilis; and have not many of the inmates been 
forced to place themselves under treatment therein, 
and thus become dependent on the City, from being 
unfitted in body and mind, for the ordinary duties 
of life, in consequence of syphilitic diseases? 

3d. Are not the children of parents thus affected 
unhealthv 1 

4th. What means, in your opinion, could be 
adopted to eradicate or lessen the disease in the 
City? 

By giving the above queries your earliest atten- 
tion, you will greatly oblige, 

Your very obt. servt. 

ISAAC TOWNSEND, 

Pmsideytt. 



*-*eu 



AT A SPECIAL MEETING 

OF THE 

MEDICAL BOARD OF BEILIMI HOSPITAL, 

Held December 18th 1855, 

The following Report, in answer to a letter from 
Isaac Townsend, ]£sq., President of the Board of 
Governors of the Alms House, dated August 24, 
1855, touching the subjects of Syphilis and Prosti- 
tution, was read by Doctor Alonzo Clark. Chair- 
man of the Committee appointed by the Medical 
Board, to consider and reply to said letter. 

On motion, the Report was accepted, and ordered 
for transmission to the President of the Board of 
Governors, after having received the signatures of 
the President and Secretary. 

JOHN T. METCALFE, M. D. 

Secretary, pro. tern., 
to the Medical Board of Bellevue Hospital. 

New- York, December, 1855. 



iprt roljrostiMim anfo j§g|His. 



To Isaac Townsend, Esq., President of the Board 
of Governors of the Alms House : 

In answer to your inquiries, the Medical 
Board of Bellevue Hospital respectfully reply : — 

That they caused a census of the Hospital to be 
taken on the 24th October last, for the purpose of 
ascertaining what proportion of the patients had 
suffered from venereal diseases. From that enu- 
meration, they learn that out of 447 persons then 
under medical and surgical treatment, 142, or about 
one-third, had been so affected. In the several di- 
visions of the house, the numbers are as follows, viz : 

Of 72 females on the surgical side, 17. or 1 in 4.24. 

Of 130 females on the medical side, 17, or 1 in 
8 nearly. 

Of 118 male patients on the medical side, 45, or 
1 in 2.6. 

Of 127 males on the surgical side, 63, or 1 in 2. 

So that out of 245 males then under treatment, 
108, or 1 in 2.27, had had some form of venereal 
disease; and among 202 females, 34, or 1 in 6 had 
been similarly affected. 



Of the whole number who confessed that they 
had had affections of this class, 106 had had 
Syphilis, and 36 had had Gonorrhoea. 

Of the 106 who had had Syphilis, 53, or just one 
half, were still laboring under the influence of the 
poison with which they had been inoculated, in 
many instances, years before. 

As almost all of these patients were admitted for 
other diseases, or with affections which the physi- 
cian alone would recognize as the remote effects of 
Syphilis, it is perhaps fair to assume that they 
represent, with some exaggeration, the class of so- 
ciety from which they come. 

The Board has been favored with the census of 
the New- York Hospital, (Broadway,) taken for the 
purpose of ascertaining the proportion of Syphilitic 
cases among the patients of that institution; from 
which it appears that the whole number of patients on 
the 8th of December was 233, and that 99 of that 
number had had venereal disease, and 37 were then 
under treatment for the same affections, recently con- 
tracted. Counting the old cases alone, most of which 
were admitted, probably, for other diseases, this 
proportion considerably exceeds that above recorded 
for Bellevue Hospital; it being as high as 1 in 2.35. 
It is proper, however, in this connection, to state, 
that the returns for Bellevue Hospital are believed 
to be incomplete. They are based in a considerable 
degree on the confessions of the patients; and it is 
known that many, especially among the women, 



have denied any contamination, when facts, subse- 
quently developed, have shown that their state- 
ments were not true. 

Is it to be believed then, that one in three, or 
even one in four, of that large class of our popula- 
tion, whose circumstances compel them to seek the 
occasional aid of medical charities, are tainted with 
venereal poison? This the Medical Board do not 
think they are authorised to state. But the facts 
here cited, and others within their reach, justify 
them in saying, that venereal diseases prevail to an 
alarming extent among the poor of this city. The 
large number of women sent by the police courts, 
to be treated for these diseases at the Penitentiary 
Hospital, would alone be sufficient evidence of this. 
Yet such persons constitute but a small proportion 
of those who, even among the poor, suffer from 
these disorders. Dispensary Physicians and those 
in private practice can show a much longer list of 
the victims of impure intercourse. 

But the disease is not confined to this class. The 
advertisements which crowd the newspapers, intro- 
duced by men who "confine their practice to one 
class of disease, in which" they "have treated 
twenty thousand cases," more or less, demonstrates 
how large is the company of irregulars who live 
and grow rich on the harvest of these grapes of 
Sodom. And yet their long list of "unfortunates" 
would disclose but a fraction of the evil among 
those who are able to pay for medical services. 
The Medical Board are unable to state what pro- 



portion of the income of regular and qualified phy- 
sicians in this city is derived from the treatment of 
venereal diseases, but they know it is large, and 
that many, who never advertise their skill, receive 
more from this source than from all other sources 
together. They believe that there is no one among 
the unavoidable diseases, however prevalent, for the 
treatment of which the well-to-do citizens of New 
York pay one-half so much as they pay to be 
relieved from the consequences of their illicit plea- 
sures. 

The city bills of mortality give little information 
regarding the frequency of venereal affections. Lues 
venerea keeps its place in the tables, and counts its 
score or two of deaths annually. Although this 
class of disorders is not frequently fatal, except 
among cluldren, it is credited with only a fraction 
of the work it actually performs. The physician 
does not feel called upon, in his return of the causes 
of death, to brand his patient's memory with dis- 
grace, or to record an accusation against near rela- 
tives. During infancy the real disease is buried 
under such terms as Marasmus, Atrophia, Infantile 
Debility, or Inflammation; while in adults, Inflam- 
mation of the Throat, Phagedena, Ulceration, Scro- 
fula, and the like, take the responsibility of the 
death. 

These affections are strictly what the advertisers 

denominate them, "private diseases," — a leprosy 

which "the unfortunate" always strives to conceal, 

• and. so long as it spares his speech and countenance, 



8 

usually succeeds in concealing". The physician is 
his only confidant — and the physician refers all to 
the class of "innocent secrets," which are not to be 
revealed. The public, therefore, know little of the 
prevalence of such diseases, and still less of the 
fearful ravages they are capable of making. 

Still, as has been just said, Syphilis is not often 
the immediate cause of death in adults. After its 
first local effects are over, (and these, though 
generally mild, are sometimes frightful,) the poison 
lingers in the system ready to break out on any 
provocation in some one of its many disgusting 
manifestations; often deforming and branding its 
victim, threatening life and making it a burthen, 
and yet refusing the poor consolation of a grave. 
Like the vulture which fed on the entrails of the 
too amorous Tityus, it tortures and consumes, but 
is slow to destroy; and often its visible brand, like 
the scarlet badge once worn by the adulteress, pro- 
claims a lasting disgrace. The protracted suffering 
of mind and body produced by this class of distem- 
pers, the ever changing and often loathsome forms 
of their secondary accidents, and the almost irradi- 
cable character of the poison, seem almost to justify 
an old opinion, sanctioned by a Papal Bull as lately 
as 1826, that these diseases are an avenging plague, 
appointed by Heaven as a special punishment for a 
special sin. 

The relentless character of Syphilitic disease 
stands out in painful relief in its transmission from 
parent to offspring. Here it is indeed, that the 



children's teeth are set on edge, because the fathers 
have eaten sour grapes. The contaminated husband 
or wife is left through years of childlessness, or of 
successive bereavements, to mourn over early 
follies, and to repent when repentance is fruitless. 
The Syphilitic man or woman can hardly become 
the parent of a healthy child. 

A young man has imbibed the contagion — it has 
become constitutional. After a few weeks, or 
months perhaps, of treatment, the visible signs of 
the disease no longer torment him. He has con- 
tracted a matrimonial alliance, and soon marries a 
healthy and virtuous woman. He natters himself 
that he is cured. A few months suffice to give him 
painful proofs of his error, for then his growing hopes 
of paternity are suddenly blasted. Instead of the 
child of his hopes, he sees a shrivelled and leprous 
corpse. This is but the first in a series of similar 
misfortunes. He has poisoned the fruit of his loins, 
and again and again, and still again it falls withered 
and dead. At length nature seems to have tri- 
umphed over this foe to domestic happiness, and 
the parents' hearts are gladdened by the prospect of 
a living child. Their joy is short-lived. The child 
is feeble and sickly, and in a few days or weeks, 
another death is added to the penance-list of the 
humbled and grieving father. 

This mournful story will need no essential changes 
in the narration, should the poison of impure inter- 
course, legitimate or illicit, linger in the veins of the 
mother. 

2 



10 

A child of such a connection may be born in 
apparent health, but before six months have passed, 
some one of the numerous forms of infantile Syph- 
ilis will be likely to appear and threaten its life. 
In the contest which follows between disease and 
the treatment, the physician is commonly victorious, 
but the contest is in many cases protracted, and 
often it is to be renewed again and again. And 
after all, it is not believed that children thus tainted 
at their birth often grow up and acquire that degree 
of health and vigor, which is popularly ascribed to 
a good constitution. 

These are facts familiar to physicians practis- 
ing in large towns. But the history of inherited 
Syphilis is not yet complete. If in the case just 
recited, the wife escape contamination from her 
husband and from her unborn child, yet the sad 
consequences of that husband's folly are not yet 
exhausted. That tainted child, now a sickly nurs- 
ling at her breast, has a venom in its ulcerated lips 
and throat, which can inoculate the mother with its 
own loathsome poison, while it draws its sustenance 
from the sacred fountain of infantile life. But this 
is not all. These little innocents sometimes spread 
their disease through the whole circle of those who 
bestow on them their care and kindness. The ut- 
most caution and cleanliness cannot always save 
those who dress their poisonous sores. The conta- 
gion spreads sometimes through the use of the same 
spoon, the same linen, and even by that highest 
token of affection, a kiss. It has been known that 
a single diseased child has contaminated its mother; 



11 



\m"J nurse; and through that nurse, the nurse's 
child; and in addition to these, the husband's mother, 
and the mother's sister. Such are sometimes the 
weighty consequences of a single error. 



PREVENTION. 

That the great source of the venereal poisons 
is prostitution, requires no argument. The first 
question then to be answered is, — Can prostitution 
be prevented? In answering this question, it is 
necessary to remember that the history of the world 
demonstrates the existence of this vice in all ages, 
and among all nations, since the day its first pages 
were written. The appetite which incites it has 
always been stronger than moral restraints — stronger 
than the law. No rigor of punishment, no violence 
of public denunciation ; neither exile, nor the dun- 
geon, nor yet the disgusting malady with which 
nature punishes the practice, has ever effected its 
extermination, even for a single year. Great as 
this evil has always been, it cannot be denied, that 
in our own time, some of the accidents of what is 
called the progress of society tend, at least in large 
towns, greatly to increase it. The expenses of living 
are everywhere the great obstacle to early mar- 
riages; whether such expenses be positively neces- 
sary, or be demanded by the social position of the 
individual— the fashion of his class— and therefore 
become relatively necessary. Whenever these ex- 
penses increase more rapidly than the rewards of 
labor, marriage becomes impossible for a constantly 



12 

increasing number, or can only be purchased at the 
price of social position. But abstinence from mar- 
riage does not abolish, or moderate the natural 
appetites. The great law of nature on which the 
existence of the race depends, is not abrogated by 
any artificial state of society. Moral or religious prin- 
ciple will restrain its operation in some ; human laws 
in some ; the fear of consequences in some ; yet there 
always have been, and probably always will be, 
many of both sexes who are not restrained by any 
of these considerations. These have sustained, and 
probably will continue to sustain, not only prostitu- 
tion, but houses of prostitution, in the face of every 
human law. Suppressed in one form, it immediately 
assumes another. Again pursued, it retreats to hid- 
ing places where darkness and secrecy protect it 
from the pursuer. 

Severe penalties have heretofore only increased 
the evils of prostitution. If a hundred women are 
consigned to prison for this vice, to-day, before a 
month has elapsed, as many more have taken their 
places ; and the hundred, though punished, are not 
reformed. Impelled by a love of their profession, 
or some by the passion to emulate the more fortu- 
nate of their sex in the finery of dress, (a passion 
which perhaps first occasioned their fall,) many by 
want, and all by a sense that they are outcasts, they 
are no sooner liberated, than they return with new 
zeal to the life from which they have been detained 
only by force. Severe laws compel secrecy — they 
can do no more. When prostitution is criminal, 
disease, if known to others, is a practical conviction. 



13 

Under such circumstances, the contaminated will be 
slow to confess disease, and so subject themselves to 
punishment. Yet their passion and their necessities 
alike forbid even temporary abstinence. They 
spread disease without limit. 

Under this fact lies an important thought. — Were 
it no more disgraceful to contract Syphilis than it is 
to have fever and ague, the diseased would seek 
early relief, which is nearly equivalent to certain 
relief, and the disorder would soon be confined to 
the pitiable few, who have lost in drunkenness and 
misery the instinctive dread of all that is foul and 
disgusting in personal disease. Prostitution, it is 
true, would then be restored to its old Roman dig- 
nity, yet venereal disease could then be reached 
and all but eradicated. But a respectable Syphilis 
does not belong to our age and nation. It lost 
caste in the beginning, and its exploits in modern 
times have not been of a character to win it friends. 
The supposition aims only to show, by contrast, the 
evils of well-intended, but probably injudicious 
legislation. Regarding pains and penalties: if the 
whip, confiscation, and banishment, in the hands of 
Charlemagne and St. Louis, aided by a right good 
will, and all the powers of a military despotism, 
could not suppress prostitution, or even prevent the 
opening of houses of prostitution; if penal laws in 
Europe, from the days of these earnest princes until 
now have utterly failed of their object, as they no- 
toriously have, it is fair to ask, how much more can 
prohibitory laws accomplish in a country, where the 
riffht of private judgment, and personaUiberty m 
speech and action, are the very foundation of the 



14 

body politic? They have hitherto been ineffectual. 
In spite of such laws the vice is increasing. In con- 
sequence of such laws, its most enormous physical evil 
is extending its baleful influence through every rank 
and circle of society. It is still emphatically the 
plague of the poor — it still brings sorrow and misery 
to the firesides of the affluent and the titled. 

An Utopian view of the perfectibility of man 
might look for the remedy to this evil in universal 
early marriages, in domestic happiness, and in a uni- 
versal moral sense, which will compel men and 
women to keep their marriage vows. But taking 
man as he is, we find the tides of society set with 
constantly increasing strength against early mar- 
riages: that domestic happiness is not synonymous 
with marriage, whether early or late: and that the 
moral sense which should teach all men to observe 
even their solemn promises, would be miraculous. 
For these things the law has done all that has been 
thought wise to attempt, probably all that it can do. 

But it may be asked, if government has the power 
to relieve society of the vice of drunkenness, why 
despair of its power regarding prostitution? In re- 
ply it may be asked, if the drunkard himself is ever 
cured of his vicious appetite by penalties? The 
Statute despairs of this. It even recognizes its in- 
ability to prevent the sale of intoxicating drinks 
while they exist; it therefore claims the right to 
seize and destroy them. Can it seize on and de- 
stroy the inborn passion which fills and supports 
houses of prostitution ? Then it cannot do for the 
one, what it hopes to do for the other. 



15 

Again, the suppression of slavery and the slave 
trade have been cited in this connection as illustra- 
ting the power of law. But these offences have no 
hiding places ; they cannot assume the guise of vir- 
tue and still be vice; they are patent as the light, 
darkness and secrecy cannot cover them. 

Prostitution is unlike any offence that is within 
the grasp of the law. In trespass, theft, or violence, 
or fraud, some one is wronged; and those who have 
been injured seek to bring the offender to justice. 
Here there is no aggrieved person. All who are in 
interest, are so in interest that they deprecate the 
interference of all law, except what they claim to 
believe is the law of nature. 

But is there no hope in the Societies of Moral 
Reform ? For the suppression or even checking of 
the general vice, none whatever. The Association 
in New York deserves much praise for its zealous 
benevolence. They have brought back some of 
these erring women to the paths of virtue, but they 
have done no more to stop the current of prostitu- 
tion, than he could do to dry up the tide of the Hud- 
son, who dips water with a bucket. In truth it may 
be said, that the paths of virtue have been found to 
be slippery places for some that would be thought 
converts. Wisdom's ways have been found to be 
too peaceful for these daughters of excitement. 
This is said in no spirit of disparagement to the 
efforts of the Society. They may well be proud 
of what they have done. But it is said to show how 
little the kindest and best can do to reclaim those 
who have once fallen from virtue and honor. 



16 

Let the great fact, then, be well understood, that 
prohibitory measures have always failed, and from 
the nature of the case must forever fail to suppress 
prostitution. 

Let this additional fact, illustrated in the foregoing 
remark, be well considered ; that penalties do not 
reform the offender, but that they enforce secrecy in 
the offence ; and silence regarding its consequences, 
which is a chief cause of the present wide diffusion 
of the venereal poison. 

What then is the proper province of Legislation 
in this important matter ? 

The wise law-giver does not attempt impossibili- 
ties. He knows that laws which experience has 
demonstrated cannot be enforced, teach disrespect 
and disobedience to all law. He knows that human 
passions cannot be changed by human legislation. 
He knows that if he attempt the impossible greater, 
in the control of vice, he is certain to neglect the 
possible and important less. He knows that the 
river will not cease to flow at his command. If it 
overflows and desolates, he raises its banks and 
dykes in the flood to prevent a general inundation. 
For hundreds of years the governments of Europe 
have tried in vain to dry up the sources of prostitu- 
tion ; with the opening of the present century, they 
began to dyke in the river and prevent avoidable 
mischief. For a long time we too have had laws 
against prostitution, which, with every proper effort 
on the part of those in authority, have proved as 



17 

Useless as those who live by this illicit traffic could 
desire, as mischievous in spreading disease as the 
quapk advertiser could wish. Is it not time then 
to inquire whether we have not attempted too 
much, whether if we attempt less, we shall not ac- 
complish more ? May we not be able to limit and 
control what we have not the power to prevent? 
If we cannot do all that a large benevolence might 
wish to accomplish, in the name of humanity, is it 
not our duty to do what is useful and practicable — • 
all that is possible. 

While the Medical Board are persuaded that by 
a change of policy, such as is suggested by the facts 
and reasons herewith submitted, much can be done 
to limit and control prostitution, and much more to- 
ward the eradication of venereal diseases, they are 
not yet prepared to offer the details of a plan by 
which they hope these important ends can be attain- 
ed. With the assistance of the Board of Governors, 
they are now in correspondence with the Medical 
officers of many of the larger cities of Europe, 
where restrictive measures have replaced prohibito- 
ry. When they have obtained the information 
which they hope this correspondence will furnish, 
they will ask leave to submit a supplementary 
Report. 

JOHN W. FRANCIS, M. D. President. 

Jno. T. Metcalfe, M. D. Secretary, pro. tern. 

Note. — It is believed that not far from 10 per 
cent, of the inmates of Bellevue Hospital are ad- 

3 



18 

mitted for affections which have their origin re- 
motely in venereal disease. A certain form of 
Rheumatism; certain inflammations of the throat, 
eye, bones, and joints; stricture, and cutaneous erup- 
tions are the most common diseases of this class. 
What proportion, if any, of those who suffer from 
Scrofula and Scrofulous Inflammations, from Con- 
sumption and other chronic diseases, owe their pre- 
sent illness to a constitutional Syphilitic vice, in- 
herited or acquired, there are no means of deter- 
mining satisfactorily. 

List of Physicians composing the Medical Board of 
Bellevue Hospital. 

Doctor John W. Francis, Doctor John A. Lidell, 

Valentine Mott, " Stephen Smith, 

Isaac Wood, " Alonso Clark, 

Alex'r H. Stevens, " Benj. W. McCready, 

James R Wood, " Isaac E. Taylor, 

Charles D. Smith, " George T. Elliot, 

Lewis A. Sayre, " John T. Metcalfe, 

John J. Crane, " G. F. Barker. 



REPORT 

OF 

DOCTOR H. N. WHITTELSEY, 

Resident Physician of Randall's Island, 

IN ANSWER TO CERTAIN QUERIES OF 

ISAAC TOWNSEND, 

Governor of the Alms House, 
UPON 

CONSTITUTIONAL SYPHILIS. 



New York, Nov. 28, 1855. 

Dear Sir, 

From repeated conversations with you, 
I am led to believe that many diseases incidental to 
the children on Randall's Island, may properly be 
traced to parents who are affected with constitutional 
"Syphilis." Please give me your views to the 
following questions, as early as 10th December. 

1st. Among the children under your care, to what 
extent does inherited Syphilitic disease exist ? 



20 

2d. Under what form does constitutional Syphilis 
present itself, and what diseases are attributable to 
its taint ? 

3d. Are not the children of parents thus affected 
unhealthy, scrofulous, subject to diseases of the eyes, 
joints, &c. 1 

Very respectfully, 

ISAAC TOWNSEND, Gov. A. H. 

Poet. H. N. Whittelsey, Resident Physician R. J. 



21 

Randall's Island, Dec. 24, 1855. 
Isaac Townsend, Esq. 

President of the Board of Governors of the 

Alms House. 
Dear Sir, 

In regard to the interrogatories contain- 
ed in jour note of a recent date, on the subject of 
hereditary Syphilis, I have the honor to reply, 

1st. Eegarding its prevalence. It is a matter of 
record that nine tenths of all diseases treated in 
this Hospital, during the past (five years,) have been 
of constitutional origin, and for the most part heredi- 
tary. These diseases assume a variety of forms, and 
involves nearly every structure of the body, termi- 
nating in Cachexia, Marasmus, Phagedena, &c. &c. 
The exact proportion which hereditary Syphilis 
bears to this sum of constitutional depravity cannot 
be stated with accuracy, for the following reasons : 

Children are admitted to this Institution between 
two and fifteen years of age, thus throwing out of 
the category, infantile Syphilis in all its forms ; and 
except in few cases, showing none of its specific 
characteristics, having been modified by appropriate 
treatment, but manifests itself by general constitu- 
tional depravity, and determines a great variety of 
diseases embracing nearly every form of skin disease, 
affection of the mucus membranes and their depen- 
dencies, diseases of the eye and ear, of the bones, 
especially of joints, &c, proving the prolific and 
lamentable source of many of the diseases incident 



22 

to children of the class presented in this Institution. 
Making then due allowance for its masked form in 
which the consequences of inherited Syphilis ap- 
pears in this Institution, together with the absence 
of (the previous history,) both of patients and par- 
ents, it is believed an approximate estimate may be 
made of the part which this malady bears to the 
sum of constitutional disease, from the foregoing facts 
and from careful observation during the past few 
years in this branch of the Alms House Depart- 
ment, it appears that human degradation is the 
source of the stream of pollution supplying this 
Hospital with disease ; and farther, that of all the 
vices which make up the sum total of depravity, 
both moral and physical, Prostitution and its conse- 
quences furnish the larger proportion. 

Here we have the sad picture presented, of a 
large number of children doomed to an early grave, 
or to breathe out their miserable existence, bearing a 
loathsome disease, carrying the penalties of vice, of 
which they themselves are innocent, being a genera- 
tion contaminated and capable only of contamina- 
ting in turn. 

In the above sketch, I have confined my state- 
ments to Syphilis as manifested in the Nursery 
Hospital, where the average number of cases of 
disease treated, is about two thousand. From this 
field is excluded every variety of the disease except 
the one (viz.) constitutional Syphilis affecting chil- 
dren, after having been modified by treatment in 
the infant 

H. N. WHITTELSEY, M. D. 



PRELIMINARY REPORT 

OF 

DOCTOR 'WILLIAM W. SANGER, 

Resident Physician of Blackwell's Island, 

IN ANSWER TO INTERROGATORIES OP 

ISAAC TO WNS E ND, 

President of the Board of Governors, 
UPON 

PROSTITUTION AND SYPHILIS. 



The following interrogatories were presented by 
the President: 

1st. — What proportion of the inmates in the In- 
stitutions on Blackwell's Island, under your medical 
charge, are, in your opinion, directly or indirectly 
suffering from Syphilis 1 

2d. — Are or are not the number of such inmates 
steadily on the increase 1 

3d, — D no t patients in the different Institutions, 
particularly in the Penitentiary Hospital, often 
leave before the disease is cured, so that they are 
liable to affect other persons after their departure T 



24 

4th. — Are not the offspring of parents affected 
with constitutional Syphilis subject to many dis- 
eases of like character, which causes them to be- 
come a charge upon the city for long periods of 
time, and often for life 1 

5th. — What are your views in reference to the 
best means of checking and decreasing this disease ; 
and what plan, in your opinion, could be adopted 
to relieve New- York City of the enormous amount 
of misery and expense caused by Syphilis 1 

6th. — You will reply, in full, to the above que- 
ries, at the earliest possible date. 

Resolved, That a copy of the above be sent to the 
Resident Physician* Blackwell's Island. 

Adopted by the Board of Governors of the Alms 
House, January 23* 1855. 



25 

Hospital, BlackweWs Island, 

December 31, 1855. 

I Townsend, Esq., 

President Board of Governors, 

Sir: 

In reply to your letter asking- for my an- 
swers to certain interrogatories on the subject of 
Prostitution and its diseases, I have to state, that I 
am not prepared to report, nor can I do so for some 
considerable length of time to come. 

Had I confined myself to the simple answering of 
the queries propounded, as regards the Institutions 
under my medical charge — simply given you the 
gross numbers, with the per centages of those who 
have suffered, or are now suffering from venereal 
disease, — such reply could have been sent to you 
long ago. A report of this kind, from this depart- 
ment, would have been looked upon by the public 
at large as containing a history in full of nearly all 
the prostitution in the city, and particularly, would 
a majority of the public have believed, that nine- 
teen-twentieths of the amount of disease resulting 
from prostitution found its home here. Such is not 
the fact. Great as is the number of prostitutes an- 
nually sent here, and enormous as is the number of 
cases of venereal disease yearly treated here, yet 
either is but a miserable fraction of the sum total 
actually existing in this city. There are but few 
more prostitutes on this Island than are to be found 
in the same number of acres in certain portions of 

4 



26 

the city ; and as for venereal disease, why, gentle- 
men, the Island has the advantage. It is the least 
dangerous locality. 

Believing, and almost positively knowing, these 
to be facts, I could not bring myself to think that 
any practical good could be accomplished by giv- 
ing you the statistics of these Institutions alone. It 
would have been merely doing what has been done 
before, and would have yielded no additional in- 
formation for your guidance. But it appeared to 
me that the time had come when your attention 
might be solicited to the various facts attending the 
aggregate prostitution of the city; for despite all 
our prohibitory laws, it is a fact which cannot be 
questioned or denied, that this vice is attaining a 
position and extent in our midst, which cannot be 
viewed without alarm. It has more than kept pace 
with the growth of our city: it has grown and 
strengthened with its growth. Unlike the vice of a 
few years since, it no longer confines itself to se- 
crecy and darkness, but boldly strides into our 
most thronged and elegant thoroughfares; and there, 
in the broad light of the sun, it jostles the honest, 
the virtuous, and the good. It is in your gay 
streets, and in your quiet home-like streets ; it is on 
your squares, and in your suburban retreats and 
summer resorts; it is in your theatres, your opera, 
your hotels; nay, it is even intruding itself into 
the private circle, and slowly but steadily extend- 
ing its poisonous fangs; known but to few, and 
entirely unsuspected by the majority of our citizens. 
The whole machinerv of the law has been turned 



27 

against these females without success, its only result 
having been a resolve, on their part, to confront 
society with the charge of harsh, cruel, and unjust 
treatment. 

From these considerations, I felt it my duty to 
obtain all the facts I could possibly collect, having 
any relation to the vice in question, for I was as- 
sured that you were desirous of taking a compre- 
hensive view of it, and I resolved, if possible, to tap 
the fountain head of prostitution and its attendant 
diseases, so as to be enabled to bring the subject 
before you in a form which should exhibit it in its 
proper colors and dimensions. 

The first step in this investigation was to obtain 
ample and reliable information of the extent of this 
vice as it exists outside of these departments, a step 
which would have been beyond my power alone. 
From the bold and reformatory stand which his 
Honor, Mayor Wood, had taken in regard to many 
matters connected with our city government, it was 
believed that he would render his assistance, if he 
could be convinced of the propriety and prospective 
usefulness of the investigation; and I am happy to 
state, that the result of an application to his Honor, 
fully established the correctness of this supposition, 
as he was found not only willing to aid in the great 
work, but fully alive to its necessity and im- 
portance. The plan he adopted to forward the 
enquiry was to take a complete census of the city, 
so far as regards prostitution, including the number 
of houses of prostitution, the number of prostitutes, 



28 

the causes which led them to become such, their 
ages, habits, birth-places, early history, education, 
religious instruction, occupation, &c, and which 
census is being now taken by the Chief and Cap- 
tains of Police. The enquiries made of all who are 
examined are as complete (if not more so) as were 
those propounded by Parent Duchatolet through 
the Prefects of Police to the prostitutes of Paris. 

Simultaneously with this, enquiries are also being 
prosecuted concerning the extent of Venereal Dis- 
ease in New- York, which will afford much interest- 
ing information. This of course will be done with- 
out any individual exposure; nor will the report, 
when complete, assume the form of a guide-book, 
by which persons can find houses of ill-fame. I 
am desirous of obtaining the aggregate facts of the 
vice, and shall be cautious to take no steps towards 
gratifying a prurient curiosity or lacerating a rank- 
ling wound. 

When these facts are before you, as I hope to be 
enabled to present them, they will be their own 
argument for the necessity of action. That they 
will be startling in the details and alarming as a 
whole, I am convinced from the progress I have 
already made. That they will, at once, commend 
themselves to your careful consideration, I entertain 
no doubt. 

I do not trouble you on this occasion with any 
remarks 'upon the deadly nature of the venereal 
poison, but when you are informed as to the fa- 



29 

cilities existing for its infusion will be the proper 
time to do so. 

Nor do I think it would be consistent with this 
stage of the enquiry, to enter into any discussion as 
to the plans that could be adopted in mitigation of 
the vice ; for although, as I have already intimated, 
prohibitory measures have failed to suppress or 
even check it, yet until its full extent is known, I 
do not imagine you would deem it prudent to at- 
tempt to grapple a monster whose strength and nu- 
merical force were not fully ascertained. 

You will perceive, that to obtain all the informa- 
tion necessary on the matter, will be a work re- 
quiring both time and labor, and I respectfully ask 
your forbearance, with the assurance that I will lay 
the result of my inquiries before you at the earliest 
possible opportunity, and with the hope that the 
magnitude and importance of the subject will be an 
apology for the time to which it is necessarily pro- 
tracted. 

I am, Sir, 

Yours, very respectfully, 

WM. W. SANGER, 

Resident Physician, BlackwelVs Island, 



37541° 

tlHeron, d. cji; 






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